HESI Pharmacology Exam Practice 2026
Original Practice Questions for RN and PN
Nursing Students
Questions 1-20
1. A nurse is preparing to administer digoxin (Lanoxin) to a client with heart failure. Which assessment
finding would require the nurse to hold the medication and notify the provider?
A) Heart rate of 72 bpm
B) Blood pressure of 130/80 mmHg
C) Heart rate of 54 bpm
D) Respiratory rate of 18 breaths/min
Correct Answer: C
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. A heart rate below 60 bpm
(bradycardia) is a common indication to hold the medication and assess for digoxin toxicity. The
nurse should check the apical pulse for a full minute before administration.
2. Which medication should the nurse anticipate administering to reverse the effects of warfarin
(Coumadin) in a client experiencing severe bleeding?
A) Protamine sulfate
B) Vitamin K (phytonadione)
C) Aminocaproic acid
D) Platelet transfusion
Correct Answer: B
Rationale: Vitamin K is the antidote for warfarin toxicity. Warfarin works by inhibiting vitamin K-
dependent clotting factors. Protamine sulfate reverses heparin, not warfarin. Aminocaproic acid
is used for fibrinolytic bleeding.
3. A client receiving furosemide (Lasix) for heart failure should be monitored for which electrolyte
imbalance?
A) Hyperkalemia
B) Hypokalemia
, C) Hypercalcemia
D) Hyponatremia only
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss through urine.
Hypokalemia is a serious side effect that can lead to cardiac arrhythmias. Nurses should monitor
potassium levels and encourage potassium-rich foods or supplements as prescribed.
4. The nurse is teaching a client about metformin (Glucophage). Which statement by the client
indicates understanding of the medication?
A) "I should take this medication with food to reduce stomach upset."
B) "I can drink alcohol moderately while taking this medication."
C) "This medication will cause me to gain weight."
D) "I should stop taking this if I feel nauseous."
Correct Answer: A
Rationale: Metformin should be taken with meals to minimize gastrointestinal side effects such
as nausea, diarrhea, and abdominal discomfort. Alcohol should be avoided as it increases the
risk of lactic acidosis. Metformin typically causes weight loss or is weight-neutral, not weight
gain.
5. Which assessment finding in a client receiving morphine sulfate requires immediate nursing
intervention?
A) Pain level decreased from 8 to 3
B) Respiratory rate of 8 breaths/min
C) Blood pressure of 110/70 mmHg
D) Client reports feeling drowsy
Correct Answer: B
Rationale: Respiratory depression is the most serious adverse effect of opioid medications. A
respiratory rate below 10-12 breaths/min indicates significant respiratory depression and
requires immediate intervention, including possible administration of naloxone (Narcan).
6. A nurse is administering insulin lispro (Humalog) to a client with type 1 diabetes. When should this
medication be given in relation to meals?
A) 30 minutes before meals
B) 15 minutes before meals or immediately after meals
Original Practice Questions for RN and PN
Nursing Students
Questions 1-20
1. A nurse is preparing to administer digoxin (Lanoxin) to a client with heart failure. Which assessment
finding would require the nurse to hold the medication and notify the provider?
A) Heart rate of 72 bpm
B) Blood pressure of 130/80 mmHg
C) Heart rate of 54 bpm
D) Respiratory rate of 18 breaths/min
Correct Answer: C
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. A heart rate below 60 bpm
(bradycardia) is a common indication to hold the medication and assess for digoxin toxicity. The
nurse should check the apical pulse for a full minute before administration.
2. Which medication should the nurse anticipate administering to reverse the effects of warfarin
(Coumadin) in a client experiencing severe bleeding?
A) Protamine sulfate
B) Vitamin K (phytonadione)
C) Aminocaproic acid
D) Platelet transfusion
Correct Answer: B
Rationale: Vitamin K is the antidote for warfarin toxicity. Warfarin works by inhibiting vitamin K-
dependent clotting factors. Protamine sulfate reverses heparin, not warfarin. Aminocaproic acid
is used for fibrinolytic bleeding.
3. A client receiving furosemide (Lasix) for heart failure should be monitored for which electrolyte
imbalance?
A) Hyperkalemia
B) Hypokalemia
, C) Hypercalcemia
D) Hyponatremia only
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss through urine.
Hypokalemia is a serious side effect that can lead to cardiac arrhythmias. Nurses should monitor
potassium levels and encourage potassium-rich foods or supplements as prescribed.
4. The nurse is teaching a client about metformin (Glucophage). Which statement by the client
indicates understanding of the medication?
A) "I should take this medication with food to reduce stomach upset."
B) "I can drink alcohol moderately while taking this medication."
C) "This medication will cause me to gain weight."
D) "I should stop taking this if I feel nauseous."
Correct Answer: A
Rationale: Metformin should be taken with meals to minimize gastrointestinal side effects such
as nausea, diarrhea, and abdominal discomfort. Alcohol should be avoided as it increases the
risk of lactic acidosis. Metformin typically causes weight loss or is weight-neutral, not weight
gain.
5. Which assessment finding in a client receiving morphine sulfate requires immediate nursing
intervention?
A) Pain level decreased from 8 to 3
B) Respiratory rate of 8 breaths/min
C) Blood pressure of 110/70 mmHg
D) Client reports feeling drowsy
Correct Answer: B
Rationale: Respiratory depression is the most serious adverse effect of opioid medications. A
respiratory rate below 10-12 breaths/min indicates significant respiratory depression and
requires immediate intervention, including possible administration of naloxone (Narcan).
6. A nurse is administering insulin lispro (Humalog) to a client with type 1 diabetes. When should this
medication be given in relation to meals?
A) 30 minutes before meals
B) 15 minutes before meals or immediately after meals
